NHS news review

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The main NHS news story today is that Health Secretary Andrew Lansley is due to announce a 60-point review of NHS performance. Lansley is expected to announce that surveys will concentrate on patients’ experience. The reviews are getting spun as imposing tough new targets on the NHS demanding improvements. It raises two issues.

Firstly, it appears very much like a top-down organisation of the NHS and is inconsistent with Lansley’s acknowledged aim to distance himself and the government from responsibility for providing and overseeing the NHS.

Secondly, following yesterday’s big news item concerning allowing private companies access to patient databases and access to drugs before they are licensed it suggests that the Con-Dem Coalition are attempting to dominate the NHS news agenda.

Pulse reports that even supportive GPs are leaving CCGs (Clinical Commissioning Groups) because of the roles’ excessive demands.

How cuts will make Britain more unfair | The wrong cure | False Economy

How cuts will make Britain more unfair

The government says that its cuts programme is not just unavoidable, but also fair and progressive. Is this true?

You can argue about the meaning of fair, but progressive has a definition. If what the government is doing is progressive it would take from the rich and give to the poor (or at least hit them much less than the rich).

Independent experts say the cuts are not progressive.

Let’s first look at the changes in tax and benefits, and then at the impact of cuts in services.

Tax and benefits

Whether changes in tax and benefits are progressive is relatively easy to measure as these are flows of cash.

The Institute of Fiscal Studies is well respected as an independent analyst. It says that the government’s claim that the tax and benefit changes in the budget and spending review are progressive is wrong.

This graph is from their analysis of George Osborne’s first budget:

June 2010 Budget: Effect of tax and benefit reforms by income decile

It shows the biggest losers are the poorest 10 per cent of families with children.

The IFS also had this to say about October’s spending review:

Our analysis (of the budget) shows that … the impact of all tax and benefit measures yet to come reduces the incomes of lower income households by more than that of higher income households, with the notable exception of the richest 2% of the population who are the hardest hit. Therefore the tax and benefit changes are regressive rather than progressive across most of the income distribution. And when we add in the new measures announced yesterday this finding is, unsurprisingly, reinforced. So our analysis continues to show that, with the notable exception of the richest 2%, the tax and benefit components of the fiscal consolidation are, overall, being implemented in a regressive way.

This is the IFS analysis of all government policies on tax and benefit by 2015. The poorest lose the most. It is only the impact of the previous government’s tax increases for the wealthy that make the top ten per cent bigger losers than some of those who are poorer.

Impact by 2015-15 of government policies

Spending cuts

Working out the impact of the cuts in spending on services is harder. Some parts of public spending benefit all of us – such as many environmental protection measures.

But other parts of public spending do benefit some people more than others. To give a simple example the richer you are, the less likely that you use the bus.

Researchers for the TUC trawled official statistics to gather information about how different income groups benefit from public spending. With these figures, and by assuming that everyone benefits equally from spending like environmental protection and defence, they were able to work out whether the cuts were progressive.

This chart shows the value of the services lost as a proportion of household income.

Value of services lost by percentage of household income

Again the impact of the cuts is much harder on the poor and those in the middle than it is on the rich. The poorest ten per cent suffer 15 times more than the richest.

The impact on women

The Womens’ Budget Group is a group of independent experts who have been working with the Treasury to analyse the effect of economic policies on women.

This is what they said about the impact of the Spending Review:

  • Lone parents and single pensioners – most of whom are women – will suffer the greatest reduction in their living standards to public service cuts. Lone parents will lose services worth 18.5% and female singles pensioners services worth 12% of their incomes.
  • Overall single women will lose services worth 60% more than single men as proportions of their incomes, and nearly three times the amount lost by couples.
  • The cuts will lead to hundreds of thousands of women losing their job. 53% of the jobs in the public sector services that have not been protected from the cuts are held by women. The pay and conditions of all public sectors workers, 65% of whom are women, are likely to deteriorate.
  • Cuts in welfare spending fall disproportionately on women’s finances. Child benefit is paid almost 100% to women; while 53% of housing benefit claimants are single women. Both benefits have been cut significantly in real terms and eligibility has been tightened.

Conservative election poster 2010

A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.

BBC News – New NHS goals are to centre on patients’ experiences

Patient surveys are to be at the centre of new goals to measure the quality of care received in the NHS in England.

Speaking at a London hospital, Health Secretary Andrew Lansley will call for focus on what matters most to patients.

The latest NHS “Outcomes Framework” stresses surveys of patients, including children, and bereaved relations.

In an interview with The Daily Telegraph, Mr Lansley said patients would be asked: “Was the service and experience you had good or not?”

Of bereaved relatives he said: “We’ll be… asking them, after a suitable passage of time, what was their loved one’s experience of care and how well were they looked after towards the end of life.”

He added: “[We will] ask children about their experience. So five to 16-year-olds would be part of this survey, with their parents, so for the first time we’ll be measuring as part of the outcomes, the children’s experience of their care.”

NHS Hospitals To Get New Goals To Improve Care And Save Over 20,000 Lives A Year | Politics | Sky News

NHS hospitals are to be measured against 60 new benchmark targets with the aim of saving more than 20,000 lives a year.

Health Secretary Andrew Lansley has said doctors and hospitals will be judged on the quality of care patients receive, rather than the speed they are treated at, in an attempt to restore faith in the system.

The NHS outcomes framework includes a focus on improving cancer survival and a zero-tolerance approach to hospital-acquired infections such as MRSA and Clostridium difficile.
…[yawn]

Tough new goals for NHS – UK – ITN.co.uk

Health Secretary Andrew Lansley will impose tough new targets on the health service on Wednesday, telling hospitals they must improve patient outcomes.

The Government is producing a 60-step plan called the NHS Outcomes Framework which will focus on improving cancer survival rates and ridding the health service of hospital-acquired infections such as MRSA and Clostridium difficile.

The plan is also designed to improve services for women and families, ensuring better maternity facilities and increasing the number of people who can access an NHS dentist.
… [yawn]

Announced by Lansley to the Torygraph: Health reforms: sixty-step plan to restore faith in the NHS – Telegraph

GPs quit CCG roles as commissioning enthusiasts lose heart – Pulse

Exclusive GP commissioning leaders are quitting the boards of clinical commissioning groups amid concerns that even enthusiasts for the NHS reforms are being ground down by excessive workload and frustration at bureaucracy.

A Pulse investigation covering 50 PCTs found 15 CCG board members have stepped down since April. Among those who resigned from board roles were CCG chairs and commissioning enthusiasts who found it impossible to juggle commissioning with their clinical work.

Board members have stepped down in Fareham and Gosport, Southampton, Wiltshire, Coventry and Warwickshire and Dorset.

Dr Patrick Craig-McFeely, a GP in Salisbury, resigned as chair of Sarum NHS Alliance commissioning group and stepped down from the CCG board last month. Dr Craig-McFeely, who was previously heavily involved in practice-based commissioning, said the experience had had a major impact on his professional and personal life.

‘It was taking over my family life and hitting the care I felt I could provide to my patients. It seemed to be getting ever worse,’ Dr Craig-McFeely said.

‘When commissioning was announced it sounded like GPs would be able to do what they thought was right. But it has shifted to us being accountable here and accountable there and a whole lot of management speak. You never seem to be making any progress.’

The time pressures on CCG chairs have also led to one of the country’s most prominent advocates of GP commissioning standing down. Dr Johnny Marshall, chair of the National Association of Primary Care, quit as chair of the United Commissioning LLP, soon to become a CCG in Buckinghamshire, after he found it impossible to devote enough time to the role alongside his other commitments.

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Conservative election poster 2010

A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.

Campaigners win delay to controversial NHS changes | This is Devon

A controversial “part privatisation” of some back office NHS functions has been put on hold after it provoked an uproar from staff.

The proposal to hand over administrative duties for the Westcountry’s family health services to a 50-50 Government and private sector partnership had enraged unions and family doctors.

After a series of meetings, the primary care trusts (PCT) , which had hoped to sign off the transfer this month, have postponed until January after conceding some issues “would benefit from greater discussion”.

Karen Williams, an organiser for the trade union Unison in Devon, welcomed the news.

“Our members are very pleased that they have been given some breathing room on this,” she said.

“While it is not a long period of time and I don’t think people will exactly be breathing a sigh of relief, members will feel that they have been paid attention to in terms of their concerns.”

Ms Williams said the union had concerns over individuals’ employment terms, as well as some larger questions about the manner of the transfer.

Under the agreement, certain administrative tasks will be transferred to the NHS Shared Business Services (SBS), a partnership between the Government and private firm Steria.

GPs in Devon and Cornwall have already voiced misgivings about SBS since the group took over invoice processing which many practices complain has resulted in late payment and bills being rejected for spurious reasons.

Former Health Minister and Exeter MP Ben Bradshaw has spoken out against the latest transfer to SBS, calling it “part-privatisation.”

Whistleblowers being ignored, RCN survey finds | News | Nursing Times

No action is taken in almost half of cases where nurses are whistleblowers about poor NHS care, according to a survey.

The poll of more than 3,000 nurses for the Royal College of Nursing (RCN) found nothing was done when fears were raised about issues including patient safety and too few staff on duty.

More than a third of nurses (34%) said they have been discouraged or told directly not to report their concerns about quality of care. Some 73% said managers had told them not to speak up, while 24% said work colleagues had said it was a bad idea.

The RCN said the results suggest pressure on staff is intensifying – in 2009, just 21% of nurses said they had been discouraged or told not to speak out.

The survey follows heavy criticism of nursing care in a series of reports from the Care Quality Commission (CQC) and the Patients Association.

It found that more than 80% of nurses had raised concerns with employers about issues relating to NHS wards. Yet 84% admitted they worried about being victimised or expected a negative effect on their career from whistleblowing. Of those who reported concerns, 38% had filled in incident forms (an official record regarding threat to patient safety), while 72% had told their line manager. Overall, just 20% of nurses said their employer took immediate action (down from 29% in the 2009 survey), while 48% said no action was ever taken (compared with 35% previously).

UK Uncut

Philip Green

Philip Green is a multi-billionaire businessman, who runs some of the biggest names on British high streets. His retail empire includes brands such as Topshop, Topman, Dorothy Perkins, Burton, Miss Selfridge and British Home Stores.

Philip Green is not a non-dom. He lives in the UK. He works in the UK. He pays tax on his salary in the UK. All seems to be in order. Until you realise that Philip Green does not actually own any of the Arcadia group that he spends every day running. Instead, it is in the name of his wife who has not done a single day’s work for the company. Mrs Green lives in Monaco, where she pays not a penny of income tax.

In 2005 Philip Green awarded himself £1.2bn, the biggest paycheck in British corporate history. But this dividend payout was channeled through a network of offshore accounts, via tax havens in Jersey and eventually to Green’s wife’s Monaco bank account. The dodge saved Green, and cost the tax payer, close to £300m. This tax arrangement remains in place. Any time it takes his fancy, Green can pay himself huge sums of money without having to pay any tax.

Before the election, the Lib Dems liked to talk tough on tax avoiders. But as soon as they entered the coalition, this pre-election bluster became just another inconvenient promise they quietly forgot. In August David Cameron appointed the country’s most notorious serial-tax avoider to advise the government on how best to slash public spending. Not a single Lib Dem minister uttered a word of complaint. A Guardian editorial denounced this as “shameful”.

Philip Green’s £285m tax dodge could pay for:

  • The full, hiked up £9,000 fees for almost 32,000 students
  • Pay the salaries of 20,000 NHS nurses

And if that’s not reason enough to take action against Sir Philip, it is worth noting that he has built his £5bn fortune on the back of sweatshop labour, using Mauritius sweatshops where Sri Lankans, Indians and Bangladeshis toil 12 hours a day, six days a week, for minimal pay.

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Conservative election poster 2010

A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.

NHS should work hand-in-glove with private firms, says Cameron – Health News – Health & Families – The Independent

A government plan to share patient records and other NHS data with private health companies ran into an immediate storm of opposition yesterday.

David Cameron will try to get the proposal back on track today when he will argue that “opening up” the health service would make it a “huge magnet” for innovation and would boost economic growth.

In a speech in London, the Prime Minister will outline plans for seriously ill patients to get quicker access to potentially life-saving new drugs before they are licensed. He will call for the NHS to work “hand-in-glove” with life science companies in a move that could give them more freedom to run clinical trials inside hospitals and access anonymised patient records. It could mean records being handed to pharmaceutical firms which carry out experiments on animals.

Privacy campaigners pointed out that the Government did not have a good record in holding personal data. In 2008, child benefit records including the details of 25 million people were lost by HM Revenue & Customs.

Guy Herbert, general secretary of the NO2ID campaign, said: “Anonymised data is like sterilised milk – it stops being that way the moment you open it up.”

David Cameron ready to put chunks of NHS up for sale, says Labour | Politics | The Guardian

Prime minister will outline plans to encourage NHS ties with industry and fuel innovation, including £180m catalyst fund


Burnham said that in principle he was not opposed to the idea of private firms getting access to some NHS data. But he said the government had to “tread carefully” in this area, and that he was concerned about Cameron’s willingness to open up the NHS to the private sector. “[Cameron] sees no limit on the involvement of the private sector and says he wants it to be a ‘fantastic business’. In his desperation to develop a credible industrial strategy, he seems willing to put large chunks of our NHS up for sale.”

Roger Gross, from the pressure group Patient Concern, said that allowing private firms access to NHS data would mean “the death of patient confidentiality”. Patient Concern resigned from a Department of Health consultation on the plan.

“”We understand GP surgeries will have the right to refuse to release their patients’ records, but whether patients will ever be told what is happening, let alone have the choice to protect their privacy, is still unclear,” Gross said.

NHS reforms costing nurses’ jobs, says MP (From The Bolton News)

THE Government has been slammed by MP David Crausby for its “wasteful” NHS reforms.

Mr Crausby, Labour MP for Bolton North East, has said guidelines requiring NHS Bolton to put a side £18,906,908 in two years are not acceptable.

“These shocking new figures show the Government’s reorganisation is costing the NHS even more than we first feared,” he said.

“It is scandalous that they are telling our local NHS to hold back millions of pounds for their own reckless plans whilst thousands of nursing jobs are being axed.

“Bolton Primary Care Trust has seen a 129 per cent rise in the number of patients waiting longer than 18 weeks for treatment since David Cameron became Prime Minister

UK Uncut

We start with some simple points of agreement. The brutal cuts to services about to be inflicted by the current Government are unnecessary, unfair and ideologically motivated. The coalition are particularly fond of two obscene catchphrases: ‘There is no alternative’ and ‘We’re all in this together.’ Both slogans are empty and untrue. The cuts will dismantle the welfare state, send inequality sky-rocketing and hit the poorest and most vulnerable hardest. A cabinet of millionaires have decided that libraries, healthcare, education funding, voluntary services, sports, the environment, the disabled, the poor and the elderly must pay the price for the recklessness of the rich.

Austerity-economics is the policy of the powerful. It cannot be stopped by asking nicely. We cannot wait until the next election. If we want to win the fight against these cuts (and we can win) then we must make it impossible to ignore our arguments and impossible to resist our demands. This means building a powerful grassroots mass movement, able to resist the Government cuts at every turn.

UK Uncut

The Government’s Line lies

 

“There is no alternative.”

We are told that the only way to reduce the deficit is to cut public services. This is certainly not the case. There are alternatives, but the government chooses to ignore them, highlighting the fact that the cuts are based on ideology, not necessity.

  • One alternative is to clamp down on tax avoidance by corporations and the rich and tax evasion, estimated to cost the state £95bn a year
  • Another is to make the banks pay for free insurance provided to them by the taxpayer: a chief executive at the Bank of England put the cost of this subsidy at £100bn in a single year

Either the tax avoided and evaded in a single year or the taxpayer subsidy to the banking industry could pay for all of the £81bn, four-year cuts programme.

“We are all in this together.”

Since the banking crisis:

David Cameron himself has said that the cuts will change Britain’s “whole way of life”. Every aspect of what was fought for by generations seems under threat – from selling off the forests, privatising health provision, closing the libraries and swimming pools, to scrapping rural bus routes. What Cameron doesn’t say is that the cuts will also disproportionately hit the poor and vulnerable, with cuts to housing benefit, disability living allowance, the childcare element of working tax credits, EMA, the Every Child a Reader programme, Sure Start and the Future Jobs Fund to name a few.

The facts speak for themselves; we are not all in this together, we are paying for the folly of reckless bankers whilst the rich profit

 

27/11/13 Having received a takedown notice from the Independent newspaper for a different posting, I have reviewed this article which links to an article at the Independent’s website in order to attempt to ensure conformance with copyright laws.

I consider this posting to comply with copyright laws since
a. Only a small portion of the original article has been quoted satisfying the fair use criteria, and / or
b. This posting satisfies the requirements of a derivative work.

Please be assured that this blog is a non-commercial blog (weblog) which does not feature advertising and has not ever produced any income.

dizzy

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John Wight: Public Sector Strike Heralds the Return of the Nasty Party

According to the Institute of Fiscal Studies, the effect of the chancellor’s latest spending proposals will be the further penalisation of the poor and more help for the better-off.

The decision not to increase tax credits will hurt the poorest in society, with the IFS predicting that the overall effect of the chancellor’s new proposals will be a reduction in the incomes of the bottom 30 percent income bracket and more children pushed into poverty.

Severe NHS cuts to nursing staff are threatening patient care.

A resignation email by Barts and the London orthopaedic consultant sparks inquiry. Consultant David Goodier wrote a shocking resignation email that recounts numerous cases of patient harm as a result of NHS cuts.

Care Quality Commission is criticised for failing to ensure quality at Stafford hospital and elsewhere.

http://www.ukuncut.org.uk/targets

The banks have run the global economy into the ground. Bankers, encouraged by the government, gambled recklessly with our money, and they lost. Spectacularly. Remember 2008? In the UK, the government decided it had to step in with a bail-out because these banks were ‘too big to fail’. According to the Bank of England, the cost of this bail-out now exceeds £1trillion. The result is that all high street banks- from Barclays to RBS- owe their existence to public financing.

What did we get for our billions? A banking system that serves ordinary people rather than the super-rich? No. Regretful bankers who refuse to reward themselves with massive bonuses? No. How about increased financial regulation to ensure this crisis couldn’t happen again? No. The government has done nothing to stop it being business as usual for banks.

What’s worse, the money that was given to the bankers is the money now being taken from the poorest in society, guaranteeing a rise in poverty, debt and inequality. Nearly £7 billion will be paid out in bank bonuses this year. This sum is more than the first wave of public spending cuts. We are not all in this together because it’s us who will pay if education, health, housing, libraries, woodland and much, much more, disappears from our lives.

Who’s telling us we must make these cuts? A government led by a cabinet of millionaires, in bed with the bankers, which is now pulling off an audacious con-trick in front of our eyes.

This is how their story goes. The crisis was caused by a bloated public sector. We binged away all our money on luxuries like healthcare and free education and council services, care for the elderly, for people with disabilities, school sports and free school meals for children living in poverty. Now the country is bankrupt and we must repent, detox, cut back. We have to relinquish our welfare state to appease the circling money men. Welcome to the Age of Austerity but don’t worry because we are all in this together.

We say – don’t believe their lies. This is their crisis, but there is no austerity for the bankers.

Conservative election poster 2010

A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.

John Wight: Public Sector Strike Heralds the Return of the Nasty Party

David Cameron’s dismissal of the huge and unprecedented national public sector strike on 30 November with his statement that it proved “a damp squib” may well come back to haunt him before the next election. It reflects a massive chasm of understanding within the coalition when it comes to the breadth and depth of anger that exists in the country over the brutal injustice that they are intent on inflicting on the vast majority in response to the greed and venality of a small minority.

Combined with the chancellor George Osborne’s Autumn Statement, Cameron’s flippant disregard for the quality of life of millions of people has ripped the mask off to reveal the nasty party in its full glory. In other words, this week has seen the Tory-led coalition unleash a full blown class war as it moves to protect the interests, privileges and wealth of their friends and backers in the boardrooms of the City as the economic crisis deepens across the eurozone and beyond.

According to the Institute of Fiscal Studies, the effect of the chancellor’s latest spending proposals will be the further penalisation of the poor and more help for the better-off.

The decision not to increase tax credits will hurt the poorest in society, with the IFS predicting that the overall effect of the chancellor’s new proposals will be a reduction in the incomes of the bottom 30 percent income bracket and more children pushed into poverty.

This continues a pattern of punishing the poor for an economic crisis not of their making, especially in light of last year’s spending review when a cap on housing benefit and swingeing cuts in disability allowances were introduced.

Midwife cuts: NHS £20 billion savings target is threatening frontline nursing care | Mail Online

  • Nurses and health care assistants make up 34 per cent of posts earmarked to be cut, finds RCN study

  • Baroness Masham says lack of leadership causing a ‘culture of indifference’ among nursing staff

The drive to find £20 billion of efficiency savings in the NHS is threatening patient care as medical staff struggle to cope with frontline cuts, it was claimed today.

Retired obstetrician Lord Patel told ministers there is now a shortfall of 4,500 to 5,000 midwives in the United Kingdom with half of the workforce aged between 45 and 55.

In a Lords debate on nursing, he said: ‘Recruitment of a younger workforce is extremely important.

‘There is a need to address the issue of a midwife shortage if we are going to deliver quality care to mothers and their children.’

Labour’s Baroness Warwick of Undercliffe added that cuts in nursing staff could have ‘disastrous consequences’ for patient care.

She said: ‘Frontline nursing care is being severely threatened by the £20 billion efficiency savings target set for the NHS.’

Analysis by the Royal College of Nursing suggested that across 41 NHS trusts in England, registered nurses and health care assistants accounted for 34 per cent of posts ‘earmarked to be cut’.

Lady Warwick said: ‘Despite Government promises that there would be no cuts to frontline NHS care, clinical services and staffing levels are being severely affected.’

Patients physically harmed by NHS cuts and bad management, says surgeon | Society | The Guardian

Resignation email by Barts and the London orthopaedic consultant sparks inquiry

An inquiry has been launched into a leading London hospital trust after a consultant claimed in a devastating resignation email that poor management and government cuts had resulted in infections, pain and starvation for dozens of patients.

David Goodier, a consultant orthopaedic surgeon at Barts and the London NHS Trust, wrote that patients with broken bones were being physically harmed as managers strove to hit waiting list targets and cut budgets.

Prof Norman Williams, the president of the Royal College of Surgeons who works part time at the hospital, has also written to the hospital’s medical council expressing his own concerns at an apparent “appalling deterioration” of surgical services. He warned that a failure to investigate could result in allegations of a cover-up similar to “Mid Staffs” – a reference to Mid Staffordshire hospital, where hundreds of patients died because of substandard care.

Now, the Royal College has been asked by the hospital to conduct an independent inquiry into Goodier’s claims and similar complaints from other members of staff.

The inquiry, uncovered by the Guardian and BBC London, will result in calls for the Department of Health and the Care Quality Commission to intervene. Goodier, 49, trained at the Royal London Hospital in Whitechapel and has worked at the trust for most of his 31 years as a junior doctor, registrar and consultant.

In his email, sent to colleagues in September, he claims that he went “ballistic” at the hospital authorities a year ago because of the lack of commitment to trauma services.

In response, he claimed, a manager “made clear that the only priorities of the trust were 18-week waiting times and the financial state”.

“We are regularly out of kit, out of nurses, out of ODPs [operating department practitioners, who plan care] and always out of beds. We have become so used to the situation, it is no longer seen as a crisis, it is the norm.”

Those who suffer are not emergency cases, he wrote, but those with less urgent needs who are left while their injuries fester.

… [continues by detailing shocking cases of neglect and consequent harm to patients.]

NHS watchdog under fire for ‘putting patient care at risk’ | Society | The Guardian

Care Quality Commission attacked after inquiry into Stafford hospital, where poor care led to hundreds of patient deaths

The watchdog responsible for overseeing the NHS came under fire on multiple fronts, with counsel for the public inquiry into the Mid Staffs hospital scandal calling into question its leadership and “unhealthy organisational culture” while the National Audit Office said its failures had risked “unsafe or poor quality (patient) care”.

In a series of withering assessments of the Care Quality Commission, at the end of the 13-month public inquiry into Stafford hospital, where poor care led to hundreds of needless patient deaths between 2005 and 2008, Tom Kark QC said the final report should consider the question of “the leadership of the CQC”.

He added: “The evidence could suggest that the CQC had an unhealthy organisational culture, and that culture goes to the top.”

The inquiry also needed to see if the CQC’s board was open to “internal criticism” and whether that allowed it to improve as an organisation, Kark said.

The chief executive of the CQC, Cynthia Bower, paid more than £195,000 a year, was formerly chief executive of the NHS West Midlands’ strategic health authority, where she was responsible for supervising the performance of Stafford hospital during the time of the scandal.

Bower was criticised by her own staff this week. On Monday the inquiry heard extraordinary testimony from employees at the CQC who publicly condemned their own bosses, including Bower, for having “no clear strategy” and presiding over a “culture of bullying” at a regulator meant to discipline poorly-run hospitals such as Stafford, which she had also been responsible for in her previous job. Kark said it was “truly surprising” to hear from these whistleblowers.

Hours after he completed his summary, parliament’s spending body, the NAO, produced a report noting that a collapse in inspections and reviews last year – from more than 13,500 to a little over 7,300 – had “increased the risk that unsafe or poor quality care went undetected”.

It also highlighted the regulator’s “shortcomings” in failing to investigate abuse of residents at Winterbourne View care home – revealed by the BBC’s Panorama programme – where “timely action was not taken to deal with poor quality care”.

Related: Neglect and indignity: Stafford hospital inquiry damns NHS failings | Society | The Guardian

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Public sector day of action on strikes yesterday.

Health workers expect the Con-Dem coalition governments health changes to increase inequalities and reduce the standard of service.

NHS workers will see any pay rises capped at 1% for two years.

There is an alternative: The case against cuts in public spending – PCS

 Tax justice

Addressing the ‘tax gap’ is a vital part of tackling the deficit. Figures produced for PCS by the Tax Justice Network show that £25 billion is lost annually in tax avoidance and a further £70 billion in tax evasion by large companies and wealthy individuals.

An additional £26 billion is going uncollected. Therefore PCS estimates the total annual tax gap at over £120 billion (more than three-quarters of the annual deficit!). It is not just PCS calculating this; leaked Treasury documents in 2006 estimated the tax gap at between £97 and £150 billion.

A comparison between levels of benefit fraud and the tax gap
If we compare the PCS estimate of the tax gap with the DWP estimate of benefit fraud, we can see that benefit fraud is less than 1% of the total lost in the tax gap (see diagram opposite).

Employing more staff at HM Revenue & Customs would enable more tax to be collected, more investigations to take place and evasion reduced. Compliance officers in HMRC bring in over £658,000 in revenue per employee.

If the modest Robin Hood tax – a 0.05% tax on global financial transactions – was applied to UK financial institutions it would raise an estimated £20-30bn per year. This alone would reduce the annual deficit by between 12.5% and 20%.

Closing the tax gap, as part of overall economic strategy, would negate the need for devastating cuts – before even considering tax rises.

Our personal tax system is currently highly regressive. The poorest fifth of the population pay 39.9% of their income in tax, while the wealthiest fifth pays only 35.1%. We need tax justice in personal taxation – which would mean higher income tax rates for the richest and cutting regressive taxes like VAT and council tax.


Cut the real waste

While it is not necessary to cut a penny in public expenditure due to the ‘deficit crisis’, there are of course areas of public spending which could be redirected to meet social needs.

In the civil and public services, we know there are massive areas of waste – like the £1.8 billion the government spent on private sector consultants last year. The government could get better advice and ideas by engaging with its own staff and their trade unions.

There is also the waste of the government having 230 separate pay bargaining units, when we could have just one national pay bargaining structure.

There are also two other large areas where government costs could be cut.

Trident

The current Trident system costs the UK around £1.5 billion every year.

A private paper prepared for Nick Clegg (in 2009, when in opposition) estimated the total costs of Trident renewal amounting to between £94.7bn and £104.2bn over the lifetime of the system, estimated at 30 years. This equates to £3.3bn per year.

At the time Nick Clegg (now Deputy Prime Minister) said: “Given that we need to ask ourselves big questions about what our priorities are, we have arrived at the view that a like-forlike Trident replacement is not the right thing to do.”

The 2010 Liberal Democrat manifesto committed the Party to: “Saying no to the like-for-like replacement of the Trident nuclear weapons system, which could cost £100 billion.”

PCS policy is to oppose the renewal of Trident and invest the money saved in public services, whilst safeguarding Ministry of Defence staff jobs.

War in Afghanistan

The war in Afghanistan is currently costing £2.6 billion per year. The war is both unwinnable and is making the world less safe. More important than the financial cost are the countless Afghan and British lives that are being lost in this conflict.


The PCS alternative…

  • There is no need for cuts to public services or further privatisations
  • Creating jobs will boost the economy and cut the deficit. Cutting jobs will damage the economy and increase the deficit
  • We should invest in areas such as housing, renewable energy and public transport
  • The UK debt is lower than other major economies
  • There is a £120 billion tax gap of evaded, avoided and uncollected tax
  • The UK holds £850 billion in banking assets from the bailout – this is more than the national debt
  • We could free up billions by not renewing Trident
  • End the use of consultants

Conservative election poster 2010

A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.

Public services union warns of more industrial action over pensions | Society | guardian.co.uk

Amid a row over the impact of the national 24-hour strike, Mark Serwotka says government needs to make further concessions

A union leader has warned that the “ball is in now in the government court” over public sector pensions and warned that further industrial action would take place if ministers failed to make further concessions.

The coalition government has said that an improved offer tabled on 2 November could be withdrawn if negotiations are not concluded by the end of the year.

Mark Serwokta, the leader of the Public and Commercial Services union, said public sector unions who took strike action on Wednesday had set themselves an earlier deadline of 15 December to decide their next move if the government did not shift its position.

Serwotka hit back at a claim by David Cameron that the mass walkout by 29 different unions across local government, health, the civil service and education had been a “damp squib”.

He said the day was “an outstanding success”, adding: “We haven’t gone on strike to have a strike, we have done it to win concessions on pensions and, in that sense, it’s the government’s move now. We hope they want to talk but, if they don’t, we have to plan for more action. The ball is very much in the government’s court. Two million people have said no to their proposals. They now need to make fresh proposals.”

A spokesperson for the Cabinet Office challenged TUC claims that up to 2 million people took action: “This figure is wrong. The figures we have show turnout was much lower than these claims and significantly less than the unions predicted. In health, civil service and local government there were approximately 900,000 people on strike. We do not have final figures for teachers.”

Disagreement between the two sides was not restricted to the pension deal or the turnout. It also rested on the nature of talks that have taken place since the last deal was tabled, with ministers insisting that talks for each pension scheme have been ongoing, while unions say discussions have either stalled or proved insubstantive.

This strike could start to turn the tide of a generation | Seumas Milne | Comment is free | The Guardian

It’s not just the scale of the walkout but the breadth that sets it apart: the ‘big society’, but not as Cameron meant it

It was the wrong time to call a strike. Industrial action would inflict “huge damage” on the economy. It would make no difference. Public sector workers wouldn’t turn out and public opinion would be against them. Downing Street was said to be “privately delighted” the unions had “fallen into their trap”.

The campaign against today’s day of action has been ramped up for weeks, and in recent days has verged on the hysterical. The Mail claimed the street cleaners and care workers striking to defend their pensions were holding the country to “ransom”, led by “monsters”, while Rupert Murdoch’s Sun called them “reckless” and “selfish”.

Michael Gove and David Cameron reached for the spirit of the 1980s, the education secretary damning strike leaders as “hardliners itching for a fight”, and the prime minister condemning the walkouts as the “height of irresponsibility”, while also insisting on the day they had been a “damp squib”.

But up to two million public employees, from teachers and nurses to dinner ladies, ignored them and staged Britain’s biggest strike for more than 30 years. The absurd government rhetoric about gold-plated public pensions – 50% get £5,600 or less – clearly backfired.

It’s not just the scale of the strike, though, but its breadth, from headteachers to school cleaners in every part of the country, that has set it apart. Most of those taking action were women, and the majority had never been on strike before. This has been the “big society” in action, but not as Cameron meant it.

And despite the best efforts of ministers and media, it has attracted strong public sympathy. The balance of opinion has varied depending on the question, but a BBC ComRes poll last week found 61% agreeing that public service workers were “justified in going on strike over changes to their pensions”.

Of course that might well change if the dispute and service disruption drags on. But the day’s mass walkouts should help bury the toxic political legacy of the winter of discontent – that large-scale public sector strikes can never win public support and are terminal for any politician that doesn’t denounce and face them down.

The Tory leadership is unmistakably locked into that Thatcher-era mindset. Not only did George Osborne’s autumn statement this week respond to the failure of his austerity programme by piling on more of the same for years to come, it was also the most nakedly class budget since Nigel Lawson hacked a third off the tax rate for the rich in 1988.

Any claim that “we’re all in this together” can now only be an object of ridicule after Osborne coolly slashed child tax credit for the low paid, propelling 100,000 more children into poverty, to fund new bypasses and lower fuel duty.

 

NHS services hit as thousands join strikes | GPonline.com

Hundreds of thousands of NHS staff are estimated to have taken part in strikes on Wednesday in protest at cuts to public sector pensions.

The strikes forced NHS services in parts of the UK to cancel operations and appointments.

Health union Unison said 400,000 NHS staff took part in industrial action across the UK – close to half the total NHS workforce.

The DoH estimate of NHS staff taking part was far lower, however. A spokeswoman said 79,000 staff – equivalent to 14% of staff in NHS trusts, foundation trusts, ambulance services and NHS Direct – did not go to work on 30 November.

Speaking in parliament on the ‘day of action’ prime minister David Cameron dismissed the strikes as a ‘damp squib’.

But Dr Ron Singer, chairman of the Medical Practitioners’ Union, a branch of public sector union Unite, said: ‘If that’s a damp squib, I hope David Cameron never witnesses a firework display by the public sector.

‘It was a fantastic show of support. To walk with people of all ages and from all backgrounds – nothing like this has happened in 30 years.’

‘Nightmare’ NHS reforms will worsen health inequalities – IFAonline

Public health experts fear the government’s plans to reform public health could be a “nightmare” that will make it harder to respond to emergencies and increase health inequalities.

They widely criticised the proposed NHS reforms and suggested the new service would be more fragmented than at present.

The vast majority also rejected one of the government’s key reasons for implementing the Bill, improving care commissioning.

These views were supported by the British Medical Association (BMA) which said the plans could cause problems when planning major events such as the next year’s London Olympics.

A survey of nearly 1,000 public health specialists conducted by the UK Faculty of Public Health (FPH) about the Health and Social Care Bill found that almost three-quarters (71%) of respondents disagreed or strongly disagreed that reforms would create a safer and more effective response to public health emergencies.

Even more (81%) disagreed or strongly disagreed that inequalities in healthcare access would fall, while 83% disagreed or strongly disagreed that the NHS would see less bureaucracy.

A similar number (79%) thought the reforms would lead to the fragmentation of the public health discipline with 50% strongly agreeing.

And three quarters (76%) disagreed or strongly disagreed that the reforms would lead to improved healthcare commissioning, one of the Department of Health’s central reasons for introducing the legislation.

The FPH said the research produced a clear message that there is ‘significant concern about public health’s future – for both the specialty itself and for the future health and wellbeing of the public’.

‘Words such as “chaos” and “nightmare” were used to describe the current and anticipated situation in the NHS and public health systems,’ it added.

The BMA noted that the findings add further weight to calls for the Health and Social Care Bill to be withdrawn.

Nursing in Practice – Public sector pay rises capped at 1% for two years

NHS workers will see any pay rises capped at 1% for two years as they prepare to bear the brunt of the UK’s shaky economy.

The cap on public sector pay will kick in during 2013 – when the current pay freeze is set to end – and is likely to be below inflation, leading to a real terms pay cut.

In his Autumn Statement, George Osborne admitted the cuts were “tough” but said the government “cannot afford the 2% rise assumed by some government departments” post 2013.

The pay cap is likely to provide savings of more than £1bn by 2014-15.

While Osborne pledged his commitment to protect NHS spending, Dr Peter Carter, Chief Executive and General Secretary of the Royal College of Nursing (RCN), claimed he has seen no evidence to support this.

Dr Carter described the cuts as “deeply provocative” and “insensitive”.

“We have always accepted that money does need to be saved but this latest attack on pay is another hammer blow to the morale of nurses, who are already in the middle of a two year pay freeze, and who are witnessing the NHS going through unprecedented upheaval,” he said.

“It is for the independent and expert pay review body to recommend an appropriate and fair deal for frontline workers – not the Government.”

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